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Nurses Give Immunization Rates a Shot in the Arm

Studies show that flu vaccination rates tend to drop around late November, but it’s important to remind your patients--and your friends--that it’s not too late to get vaccinated The CDC recommends an annual flu vaccine for everyone ages six months and older, including pregnant women and people who are at increased risk for developing complications as a result of the flu.

One way to show your support for immunization efforts is to “Take the Pledge” and find more resources for nurses on the ANA Immunize website. And if you haven’t made time for the vaccine yourself yet, it’s time to roll up your own sleeve--or get the flu mist.

By Jennifer Larson, contributor

December 13, 2012 - Katherine Sebert, RN, never met her aunt because she died of diphtheria before Sebert was born. But Sebert keeps her aunt’s framed death certificate in her office to inspire her to advocate for immunization of preventable diseases.

As coordinator for the Tulsa Area Immunization Coalition in Oklahoma, Sebert is passionate about her work. She was even commended by the American Nurses Association in 2011 for her work to promote vaccination in her community. The coalition that she oversees continually works to create and launch collaborations to increase the vaccination rate.

Nurses like Sebert can and do make a big difference when it comes to educating people about the benefits of vaccinations. In fact, a recent study by a team of Canadian researchers, published in the Annals of Family Medicine, noted that nurses can play a major role in boosting immunization rates for diseases like influenza and pneumonia.

The researchers reviewed studies that involved interventions mostly with elderly patients. They found that interventions that lean heavily on the personal contact tend to be the most effective, and immunization rates tend to go up when the responsibility is shifted from doctors to nurses and other non-physician personnel like pharmacists.

But a combination of efforts may have the most potential, said Jeffrey Johnson, PhD, a professor in the school of public health at the University of Alberta and one of the study’s authors.

“We need to think about creating more potent types of combinations of interventions,” he said.

Educators with a personal touch

Nurses indeed can be powerful and effective advocates for vaccination, said Katie Brewer, MSN, RN, senior policy analyst for the American Nurses Association (ANA). They are the most trusted health care professionals, as proven year after year in national surveys; this gives them the opportunity to use their influence as scientists and clinicians.

“And people are generally very receptive to that,” said Brewer.

Michelle Flaig, RN, received an ANA Immunity Award for helping to double the flu vaccination rates among employees in her health system in four yours.

Nurses are caregivers and educators, so it’s a natural fit, said Michelle Flaig, RN, an employee health nurse with Nix Health in San Antonio, Texas. They usually have more time than doctors to sit down with patients and explain the vaccinations to them--and answer questions.

For example, if you find that a patient is unclear about the options available to him, this gives you the chance to explain in more detail the types of vaccines that are available. You could explain that the flu vaccine is available as either an intramuscular injection of the inactivated injectable influenza vaccine or the live attenuated influenza vaccine (LAIV) that is administered intranasally. You can also explain which type of vaccine is appropriate for certain people and discuss side effects. And you can do all of this with the respect that many people desire, acknowledging any misgivings they may have and making them feel that you really do have their best interests at heart.

“You have to make it so they can understand it and feel comfortable to ask questions and not feel rushed,” Flaig noted.

Flaig also has found success by informally educating people about the benefits of vaccination--something that other nurses could do, too. When she’s out in the community and hears people talking about the flu or why they didn’t get a flu shot, she just asks them to tell her about that. Then she calmly and respectfully counters any misinformation.

“Nurses are so involved in their communities--with their churches, with their schools, at home—that they can teach or educate people by just asking if they’ve had their flu shot,” and going from there, added Sebert.

Walking the talk

But it’s also important that nurses be role models if they want to encourage others to get vaccinated. “Because they should be practicing what they preach,” said Sebert.

The Advisory Committee on Immunization Practices (ACIP) recommends that all health care professionals get an annual influenza vaccine. That includes nurses, who by virtue of working in health care settings, are exposed to many infectious agents. A vaccine reduces their chances of becoming ill themselves or spreading the virus to their patients, some of whom may have an increased risk for severe, even life-threatening complications from the flu.

Unfortunately, statistics show that many health care professionals haven’t fully grasped the importance of vaccination themselves. The Occupational Safety and Health Administration calls the current rate of influenza vaccination by health care workers, which is about 64 percent, “disappointing.”

The U.S. Department of Health and Human Services’ Healthy People 2020 program has set a goal to vaccinate 90 percent of health care workers, so there is obviously still a long way to go. Some promise of success has been seen in programs such as The Joint Commission’s Flu Vaccination Challenge, however, which has achieved an 80 percent vaccination rate among participants.

Flaig made a big dent in the vaccination problem in her own backyard by getting creative. She marshaled resources to boost the sagging flu vaccination rate among fellow employees of her health care system. She managed to double the vaccination rate from 35 percent to 72 percent in four years by putting resources toward new programs to encourage vaccination…and the rate continues to rise. For example, employees who claimed they didn’t have access to flu shots because they worked nights or weekends found a nurse popping up on their unit at odd hours, ready to dispense a flu vaccine.

“The people who said it was inconvenient could no longer say that,” said Flaig, who received an ANA Immunity Award for her efforts.

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